Orthopedists specialize in the diagnosis, treatment, rehabilitation and prevention of injuries to and diseases of the musculoskeletal system - the network of bones, joints, ligaments, tendons, muscles and nerves that gives the body its shape and allows us to move.
Many of the problems orthopedists treat involve the joints, places in the body where two or more bones meet. Humans have three different kinds of joints: fibrous (in the skull), cartilaginous (in the spine) and synovial (the neck, shoulders, elbows, wrists, hands, hips, knees, ankles and feet). This last type is what we usually refer to when we say "joint." Ligaments connect bones to each other, and tendons connect muscles and bones.
Arthroscopy is a minimally invasive procedure that allows doctors to diagnose and sometimes treat joint injuries and disease through small incisions in the skin. It is often performed to confirm a diagnosis made after a physical examination and other imaging tests such as MRI, CT or X-rays.
During an arthroscopic procedure, a thin fiberoptic light, magnifying lens and tiny television camera are inserted into the problem area, allowing the doctor to examine the joint in great detail.
For some patients it is then possible to treat the problem using this approach or with a combination of arthroscopic and “open” surgery. Sports injuries are often repairable with arthroscopy. Tendon tears in the knee are frequently repaired in this way. Other potentially treatable injuries include torn cartilage or ligaments, inflamed joint lining, carpal tunnel syndrome, rotator cuff tears, and loose bone or cartilage.
The structures of our musculoskeletal system - the bones, joints, ligaments, tendons and other tissues - are highly susceptible to damage caused by trauma from accidents, injuries and other events. These traumatic events may include a fall, automobile accident or sports injury, and often include a direct blow or twisting on a specific area of the body, causing pain, swelling, inflammation and other sometimes serious complications.
At Urgent Orthopaedic Care, we provide comprehensive trauma care for all types of falls, accidents or injuries. Dr. Gendelman is experienced in everything from performing emergency surgeries to administering physical rehabilitation programs.
Treatment for accidents or injuries can vary depending on the type, severity and location of the affected area, as well as the patient's overall health. Most treatment courses usually begin with conservative methods and only consider surgery as a last resort. Physical rehabilitation is often needed in order to restore movement and function to the affected area as it heals.
A hip fracture is a break in the top of the femur (thighbone) where the bone angles toward the hip joint. If the break occurs within two inches of the joint, it is called a femoral neck fracture. If it occurs between two and four inches from the joint, it is known as an intertrochanteric fracture. (A break further down the bone is classified as a broken femur rather than a broken hip.) Femoral neck fractures require more extensive surgery.
Sometimes the best way to relieve pain and restore function to a joint is to replace all or part of it with a prosthesis (an artificial joint). Prostheses are intended to restore function to the joint and relieve pain associated with arthritis, other chronic conditions, or traumatic injury.
Prostheses are designed to move like a regular joint. They are made of durable plastic and metal parts that fit together snugly but glide smoothly (as opposed to the painful friction associated with the worn cartilage of arthritic joints). The pieces are shaped like the structures they replace - for example, the damaged bones in a ball-and-socket joint of a hip or shoulder are replaced with a metal ball and plastic socket. They are held to the surrounding bone either with a locking mechanism or with a special bone cement.
The length and difficulty of recovery depend on the location of the joint replaced as well as the patient's age and overall health. Hip or knee surgery typically requires temporary use of a cane or walker. Some pain and stiffness following surgery is normal. Gradually, the weakened muscles regain strength and flexibility as the patient becomes accustomed to using the joint. The physician will discuss when it is safe to return to any athletic activities. Once in place, prostheses usually perform well for up to a decade or longer.